Publication: The Contentious Management of Anaplastic Thyroid Carcinoma with Acute Airway Obstruction during COVID-19 Pandemic
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Date
2021-06
Journal Title
Journal ISSN
Volume Title
Publisher
USIM Press
Abstract
There are many important concerns and issues raised in managing acute airway obstruction cases with regards to the current COVID-19 pandemic. As a further matter, a patient with a huge thyroid mass in anaplastic thyroid carcinoma (ATC) presenting with impending airway obstruction poses treatment challenges, as immediate active intervention is necessary despite the risk of spreading of COVID-19 viruses. The unknown status of COVID-19 of the patient will add additional concerns during active assessment and treatment as patients with this undifferentiated thyroid carcinoma commonly deteriorate fast. This carcinoma may also invade the trachea and result in upper airway obstruction leading to a fatal outcome. Therefore, an appropriate treatment strategy is essential. This report highlights a case of an ATC patient who presented with diffuse cemented-hard anterior neck, whereby the whole management of ATC with acute airway obstruction during this COVID-19 pandemic is purely contentious and challenging. The issue of providing artificial ventilation either via intubation or tracheostomy is made more complicated as the patient presents with an acute upper airway obstruction whilst the COVID-19 status is unknown. While endotracheal intubation approach was not easy, the trachea was also difficult to be identified externally due to the huge ‘cemented-hard’ mass plastered over the compressed trachea. Due to the advanced disease, surgical intervention was not an option.
Description
ULUM ISLAMIYYAH The Malaysian Journal of Islamic Sciences (Special Issue IHEC 02-2021) [June 2021]
Keywords
Coronavirus disease 2019, thyroid cancer, upper airway obstruction, Malaysia
Citation
Mohd Safian, A. I. ., Ibrahim, K. ., Mohd Isa, S. A. ., Mat Lazim, N., & Mohamad, I. (2021). The Contentious Management of Anaplastic Thyroid Carcinoma with Acute Airway Obstruction during COVID-19 Pandemic. Ulum Islamiyyah, 33(3), 1-11. https://doi.org/10.33102/uij.vol33no3.314